Pediatric Liver Diseases/Liver Transplantation Program

RMTI’s protocol for treating patients with hilar cholangiocarcinoma (CCA) was approved by the UNOS Liver and Intestinal Organ Transplantation Committee on June 17, 2010, offering new hope for CCA patients who ordinarily would not qualify for transplantation.

– July 14, 2010 /Press Release/ ––

RMTI’s protocol for treating patients with hilar cholangiocarcinoma (CCA) was approved by the UNOS Liver and Intestinal Organ Transplantation Committee on June 17, 2010, offering new hope for CCA patients who ordinarily would not qualify for transplantation.

Patients who meet protocol criteria will be eligible for priority on the UNOS liver transplant waiting list. Additionally, for every three months that patients continue to meet the criteria, their placement on the waiting list will increase in priority.

Hilar cholangiocarcinoma: Difficult to treat

Hilar cholangiocarcinoma is a condition in which tumors originate from the bile ducts outside the liver. These tumors are very difficult to treat and frequently cause symptoms in the later stages of the disease, when surgical resection is no longer an option.

While surgical resection — the removal of a portion of the liver — is considered the primary curative treatment for certain patients, the overall survival rate after five years ranges from only 20 percent to 40 percent. Furthermore, many patients who have hilar cholangiocarcinoma are unable to undergo surgery due to existing liver disease, the location of the tumor, or the tumor’s involvement with the blood vessels. Liver transplantation provides an option for those who would not qualify for surgery because of poor liver function.

Protocol expands post-transplant therapies

In order to improve post-transplant outcomes for CCA patients and to achieve results similar to those of liver transplant recipients with other chronic liver diseases — an average 5-year survival rate of 75 percent — interest has been focused on neoadjuvant or pre-surgical treatment options. These treatment protocols involve radiotherapy and chemotherapy in highly selected patients and have shown encouraging results. RMTI’s protocol combines the benefits of radiotherapy, chemotherapy, with liver transplantation as a hope for cure.

Besides enabling more patients to qualify for transplantation, we anticipate that this will further define the role of these treatment protocols and transplantation in this difficult patient group and provide improved long-term survival.